Three children who presented with steroid-resistant airflow obstruction are described. They all had bronchomalacia in the setting of a rare visceral arrangement, namely left bronchial isomerism with normal atrial arrangement. Imaging and, in two cases, a normal residual volume in the face of severe airflow obstruction were diagnostic pointers to a nonasthmatic cause of wheeze. Although the asso...

there are significant overlaps in clinical, physiological and pathological features of the two diseases, including the mechanisms of bronchial hyperresponsiveness and atopy that drive obstructive phenotypes [7]. Although asthma may progress to chronic irreversible airflow obstruction, changes in reversibility over time are not widely reported [8, 9]. It may be that we require a new taxonomy to ...

FOR Evidence for the inflammatory basis of asthma comes from bronchial biopsies, which show inflammation of the mucosa even in patients with mild intermittent asthma. Mucosal oedema and excess mucus production cause reduction in the lumen and obstruction to airflow. Bronchospasm occurs as the natural “foreign body” response to irritation caused by inflammation, the bronchi become hyperactive an...

BACKGROUND Exhaled breath temperature (EBT) has recently been proposed as a noninvasive marker of bronchial inflammation in patients with asthma. However, the usefulness of EBT in everyday clinical practice is not well established. Results to date are contradictory and are mainly derived from small, pediatric populations. A comparison of results is further complicated by the use of different eq...

INTRODUCTION Bronchial asthma is a serious global health problem. 5% to 10% of persons of all ages suffer from this chronic airway disorder. This review article presents important considerations of diagnosis and treatment in view of the current national and international asthma guidelines. METHODS Selective literature review, with attention to the current national and international guidelines...

This paper describes a disease pattern with a distinctive clinico-radiological picture but of an undetermined pathology. The main features are quietening of the breath sounds and lessening of the radiographic lung markings with persistently greater transradiancy over one lung, the condition being distinguishable from simple unilateral obstructive emphysema by the small or normal size of the aff...

BACKGROUND Wheezing occurs in both atopic and non-atopic children. The characteristics of atopic and non-atopic wheeze in children at 10 years of age were assessed and attempts made to identify whether different mechanisms underlie these states. METHODS Children were seen at birth and at 1, 2, 4 and 10 years of age in a whole population birth cohort study (n = 1456; 1373 seen at 10 years). In...

BACKGROUND the relationships between atopy and chronic airflow obstruction and bronchial hyperresponsiveness in adults are unclear. We measured airways calibre (FEV1), bronchial responsiveness, eosinophil count and total serum IgE in a random population sample of adults aged 45 years or older. METHODS Caucasian adults (n = 783) were selected from the practice lists of local general practition...

IT IS appropriate, in celebrating the great contribution which John McMichael has made to the physiological approach to medicine, to deal with a physiological subject. This paper gives a brief account of the investigations, still somewhat preliminary, which our group has been carrying out into the possible part played by bronchial muscle in airways obstruction. If increased tone of bronchial mu...

BACKGROUND Diffuse panbronchiolitis (DPB) is characterised clinically by chronic airflow limitation and respiratory tract infection, and pathologically by chronic bronchiolar inflammation. To elucidate the functional differences between chronic obstructive pulmonary disease (COPD) and DPB the bronchial responsiveness to methacholine was compared in 64 patients with COPD and 32 patients with DPB...